Gundermann C, Meier-Hellmann A, Bauer M, Hartmann M
Universitätsklinikum Jena.
Dtsch Med Wochenschr. 2010 May;135(3):67-70. doi: 10.1055/s-0029-1244818. Epub 2010 Jan 14.
Several hospitals have issued their own guidelines that regulate the conduct of staff members toward the pharmaceutical industry. The effect of theses guidelines on the attitude of the doctors toward the pharmaceutical industry in Germany has so far been unknown. This study investigated whether hospital doctors with guidelines and those without guidelines differ in their attitude toward the pharmaceutical industry.
A retrospective analysis was undertaken to determine the influence of hospital guidelines on the attitude of doctors toward the pharmaceutical industry. In May 2008 all doctors in intensive care of a hospital with and one without guidelines were asked anonymously by a questionnaire about their dealings with the pharmaceutical industry. The response rate was 64.9 % (37/57) and 55.1 % (59/107) respectively. The cooperation rate in both groups was 100 %.
In the hospital with guidelines every doctor was on average carrying 0.56 +/- 0.64 pharmaceutical advertising gifts with a company logo, while the average in the institution without guidelines was 1.2 +/- 0.61 advertising gifts (p = 0.026). Whereas 49 % of doctors with guidelines considered the acceptance of advertising gifts as not questionable, 81 % without guidelines did (p = 0.001; RRR = 0.65; 95 % CI = 0.48-0.91). Furthermore, 70 % of doctors in the institution with guidelines compared with 92 % of those doctors in the hospital without guidelines believed that the advertising practices of the pharmaceutical industry had no influence on their prescribing behaviour (p = 0.010; RRR = 3.6; 95 % CI = 1.36-9.52). Both groups of doctors are convinced that other doctors are more influenced by the pharmaceutical industry than they are themselves (51 % with and 37 % without guidelines, p = 0.207). 70 % and 90 %, respectively of all participants considered hospital guidelines setting standards of conduct toward the pharmaceutical industry and those not sponsored by industry to have a positive effect. Every other doctor additionally stated the advice by the pharmaceutical industry was not helpful for his work.
Hospital guidelines on relations with the pharmaceutical industry appear to further a critical attitude by physicians regarding the pharmaceutical industry.
多家医院已发布各自的指南，规范工作人员与制药行业的行为。这些指南对德国医生对制药行业态度的影响迄今尚不清楚。本研究调查了有指南和无指南的医院医生在对制药行业的态度上是否存在差异。
进行回顾性分析，以确定医院指南对医生对制药行业态度的影响。2008年5月，通过问卷调查，对一家有指南和一家无指南医院的所有重症监护医生进行匿名询问，了解他们与制药行业的往来情况。回复率分别为64.9%（37/57）和55.1%（59/107）。两组的合作率均为100%。
在有指南的医院，每位医生平均持有0.56±0.64件带有公司标志的药品广告礼品，而在无指南的机构中，平均为1.2±0.61件广告礼品（p = 0.026）。有指南的医生中49%认为接受广告礼品无可厚非，无指南的医生中这一比例为81%（p = 0.001；相对危险度降低率=0.65；95%可信区间=0.48 - 0.91）。此外，有指南机构中的70%医生与无指南医院中的92%医生认为制药行业的广告行为对他们的处方行为没有影响（p = 0.010；相对危险度降低率=3.6；95%可信区间=1.36 - 9.52）。两组医生都确信其他医生比他们自己更容易受到制药行业的影响（有指南的为51%，无指南的为37%，p = 0.207）。所有参与者分别有70%和90%认为医院指南为与制药行业的行为设定了标准，且那些非行业赞助的指南有积极作用。另外，每隔一位医生表示制药行业的建议对他的工作没有帮助。
医院关于与制药行业关系的指南似乎有助于医生对制药行业形成批判性态度。
